It innervates all internal organs. Vegetative innervation of internal organs
The spinal cord is one of the most important parts of the human nervous system. It is a collection of nerve cells and connective tissue carries information from the brain to muscles, skin, internal organs, that is, to all parts of the body mutually.
The spinal cord begins at the base of the brain (Fig. 1), goes from the medulla oblongata and passes through the canal tube formed by other vertebrae.
The spinal cord ends in the first lumbar vertebra with a large number of fibers that stretch to the end of the spine and attach the spinal cord to the tailbone.
From the spinal cord through the holes in the arches of the vertebrae, nerve fibers depart, serving different parts of the body.
In fig. 3 and in Tables 1 and 2, the segments of the spinal cord, which innervate various internal organs and muscular systems, are marked and indicated. Each segment is responsible for a specific part of the human body.
In length, the spinal cord consists of 31 pairs of nerve fibers: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, one coccygeal. Sensory nerve roots are attached to the back of the spinal cord, motor nerve roots to the front. Each pair of fibers controls a specific part of the body.
Figure: 3. Segmental innervation internal organs and muscular systems: C - cervical; D - thoracic region; L - lumbar; S - sacral section.
Numerical designations - the serial number of the vertebra
A logical question arises: what does the sentence "spinal cord injury" mean - a sentence often accompanied by a medical diagnosis of "spinal fracture"?
With a spinal cord injury, the brain's communication with the part of the body below the injury is interrupted and its signals do not pass. The greater the disruption in communication, the more severe the consequences of the injury. Thus, an injury at the level of the cervical vertebrae causes paralysis of all four limbs, loss of sensitivity of most of the body and disruption of the functioning of internal organs, up to breathing. Trauma at a lower level (thoracic or lumbar) causes immobility only of the lower limbs and disruption of the internal organs located in the pelvis.
Conscious actions come from the brain, but, becoming reflexive, are transferred to the management of the spinal cord, that is, the brain programs the order of actions. In the "databank" already at birth, its role in the control of respiration, heartbeat, blood circulation, digestion, excretion and reproduction functions was determined. Countless daily activities - walking, eating, speaking, etc. - have been programmed from childhood.
Each nerve functions normally if the spine is stretched, straight, strong and flexible. If the spine is shortened, the distance between the vertebrae decreases, and the nerves exiting through the openings of the vertebral arches (Fig. 1) are compressed.
Table 1
When the fibers in the upper part of the neck are compressed, a person has severe headaches. When the nerves of the chest are squeezed, a digestive upset is caused. Exposure to nerve fibers located just below can affect the intestines and kidneys.
Tables 1 and 2 provide detailed information on the segmental innervation of internal organs. From them it is clear that there is no part of the body that the vertebral nervous system does not act on.
table 2
If the spine is subjected to overstrain or sudden impacts, the vertebral disc can burst, and the gelatinous mass of the nucleus through the outer shell can enter the spinal canal - "tube". This is how a herniated disc is formed (Fig. 1). A deep displacement of the disc into the canal can place strong pressure on the spinal cord and even cut off many bodily functions below the level of the hernia. In addition, the vertebrae, deprived of elastic support, rub against each other and can pinch the nerve that leaves the spinal cord.
However, not every spinal injury leads to impairment of the spinal cord and its functions. There are cases when, when falling, a person damaged several processes of the vertebrae and remained not only alive, but also completely healthy. With several fractures of the vertebral bodies, the brain may not be mechanically injured, but only temporarily - even up to a year - "shut down", just as it happens with the brain with a strong concussion. Therefore, a spinal fracture in itself does not yet lead to permanent disability. In such cases, they say: "I got off with a slight fright ..." - and, having laid down the prescribed months, the patient safely gets to his feet.
It happens the other way around: the spinal cord is damaged with the whole or almost the whole spine. This happens when stabbed or gunshot wounds, electrical injuries or tumors, viral diseases or (in rare cases) hemorrhages of nearby vessels.
Afferent innervation of internal organs and blood vessels is carried out by nerve cells of sensitive nodes cranial nerves, spinal nodes, as well as vegetative nodes (I neuron). Peripheral processes (dendrites) of pseudo-unipolar cells follow as part of the nerves to the internal organs. The central processes are part of the sensitive roots in the brain and spinal cord. Body II neurons are located in the spinal cord - in the nuclei of the posterior horns, in the nuclei of the thin and wedge-shaped bundles of the medulla oblongata and the sensory nuclei of the cranial nerves. Axons of the second neurons are directed to the opposite side and, as part of the medial loop, reach the nuclei of the thalamus (III neuron).
The processes of the third neurons end on the cells of the cerebral cortex, where awareness occurs pain... The cortical end of the analyzer is located mainly in the pre- and postcentral gyri (IV neuron).
The efferent innervation of various internal organs is ambiguous. Organs, which include smooth involuntary muscles, as well as organs with a secretory function, as a rule, receive efferent innervation from both parts of the autonomic nervous system: the sympathetic and parasympathetic, causing the opposite effect.
Excitation sympathetic division the autonomic nervous system causes an increase and increase in heart rate, an increase in blood pressure and blood glucose levels, an increase in the release of hormones of the adrenal medulla, dilation of the pupils and the lumen of the bronchi, a decrease in the secretion of glands (except for sweat glands), spasm of sphincters and inhibition of intestinal motility.
Excitation parasympathetic department the autonomic nervous system lowers blood pressure and blood glucose (increases insulin secretion), cuts and weakens heart contractions, narrows the pupils and bronchial lumen, increases glandular secretion, enhances peristalsis and reduces the muscles of the bladder, relaxes the sphincters.
SENSE ORGANS
Introduction
The sense organs are sensory systems. They contain the peripheral ends of the analyzers, protecting the receptor cells of the analyzers from adverse effects and creating favorable conditions for their optimal functioning.
According to I.P. Pavlov, each analyzer consists of three parts: the peripheral part - receptor, which perceives irritations and transforms them into a nerve impulse, conductive transmitting impulses to the nerve centers, centrallocated in the cerebral cortex (cortical end of the analyzer), which analyzes and synthesizes information. Thanks to the sense organs, the body's relationship with the external environment is established.
The sense organs include: the organ of vision, the organ of hearing and balance, the organ of smell, the organ of taste, the organ of tactile, pain and temperature sensitivity, the motor analyzer, the interoceptive analyzer.
The motor analyzer is described in detail in the chapter “The Central Nervous System. Pathways ", and about the interoceptive analyzer - in the chapter" The Autonomic Nervous System ".
Organ of vision
Eye, oculus, consists of eyeball and surrounding subsidiary bodies.
Eyeball, bulbus oculi, is located in the eye socket and has the form of a ball, more convex in front. Distinguish between its front and rear poles. The straight line passing through the poles is called the visual axis of the eye. The eyeball is composed of three membranes: fibrous, vascular, retina, surrounding the inner nucleus of the eye (Fig. 1).
Fibrous membrane, tunica fibrosa bulbi, is a derivative of the mesoderm, located outside, performs a protective function and serves as a place of muscle attachment. It is distinguished: the back section - sclera or tunica albuginea, which is a dense connective tissue plate of white color and the anterior section - cornea, it is a more convex transparent part of the fibrous membrane, reminiscent of a watch glass, which belongs to the light refracting media of the eye. It has a large number of nerve endings and is devoid of blood vessels, has a high permeability, which is used for the introduction of medicinal substances. On the border of the cornea and the sclera in the thickness of the latter, the venous sinus of the sclera is located, into which the fluid outflows from the anterior chamber of the eye.
Fig. 1. Diagram of the eyeball. 1 - sclera; 2 - cornea; 3 - the choroid itself; 4 - retina; 5 - iris; 6 - iridescent corneal angle; 7 - lens; 8 - vitreous body; 9 - anterior chamber; 10 - rear camera; 11 - yellow spot; 12 - optic nerve.
Choroid, tunica vasculosa bulbi, like fibrous develops from the mesoderm, is rich in blood vessels, is located inward from the fibrous membrane. Three sections are distinguished in it: the choroid itself, the ciliary body and the iris.
Choroid itself, choroidea, makes up 2/3 of the choroid and is its posterior part. Between the adjacent surfaces of the choroid itself and the sclera there is a slit-like perivascular space, which allows the choroid itself to move during accommodation.
Ciliary bodycorpus ciliare - the thickened part of the choroid. The location of the ciliary body coincides with the junction of the sclera into the cornea. The anterior part of the ciliary body contains about 70 ciliary processes, which are based on blood capillaries that produce aqueous humor. From the ciliary body, the fibers of the ciliary girdle (zinn ligament) begin, which is attached to the lens capsule. The thickness of the ciliary body is the ciliary muscle, m. ciliaris participating in accommodation. With tension, this muscle relaxes the ligament, and through it the lens capsule, which becomes more convex. When the Zinn muscle is relaxed, the ligament is stretched, and the lens becomes flatter. The atrophy of muscle fibers occurring with age and their replacement by connective tissue leads to a weakening of accommodation.
Iris or irisiris, makes up the anterior part of the choroid and looks like a disc with a hole in the center - pupil... The base (stroma) of the iris is represented by connective tissue with vessels located in it. In the thickness of the stroma there are smooth muscles: circularly located muscle fibers that constrict the pupil, m. sphincter pupillae, and radial fibers dilating the pupil, m. dilatator pupillae. Thanks to the muscles, the iris acts as a diaphragm, regulating the amount of light entering the eye. The anterior surface of the iris contains the pigment melanin, the varying amount and nature of which determines the color of the eyes.
Retina, retina - the inner shell of the eyeball. Develops from the outgrowth of the anterior brain bladder, which turns into an ophthalmic vesicle on a pedicle, and then into a double-walled glass. The retina is formed from the latter, and the optic nerve is formed from the leg. The retina consists of two sheets: the outer pigment and the inner photosensitive ( nervous part). According to function and structure, two parts are distinguished in the inner leaf of the retina: visual, pars optica retinaecontaining light-sensitive elements (rods, cones) and anterior blind, pars caeca retinaecovering the posterior surface of the iris and the ciliary body, where there are no light-sensitive elements. The optic nerve forms in the back of the retina. Its exit point is called a disc optic nervewhere rods and cones are missing (blind spot). Lateral to the optic nerve head is rounded yellow spot, maculawhich contains only cones and is the site of the greatest visual acuity.
Inner core of the eye
The inner core of the eye consists of transparent light-refracting media: the lens, vitreous humor and aqueous humor.
Lens, lens, develops from the ectoderm and is the most important light refracting medium. It has the shape of a biconvex lens and is enclosed in a thin transparent capsule. From the capsule of the lens to the ciliary body, the Zinn ligament extends, which serves as a suspension apparatus for the lens. Due to the elasticity of the lens, its curvature easily changes when viewing objects at a long or close distance (accommodation). When the ciliary muscle contracts, the fibers of the zinn ligament relax, and the lens becomes more convex (setting for near vision). Relaxation of the muscle leads to stretching of the ligament and flattening of the lens (setting for distant vision).
Vitreous humor corpus vitreum - a transparent jelly-like mass lying behind the lens and filling the cavity of the eyeball.
Watery moisture produced by the capillaries of the ciliary processes and fills the anterior and posterior chambers of the eye. It is involved in nourishing the cornea and maintaining intraocular pressure.
The anterior chamber of the eye is the space between the anterior surface of the iris and the posterior surface of the cornea. Along the periphery, the anterior and posterior walls of the chamber converge, forming an iridescent-corneal angle, through the slit-like spaces of which aqueous humor flows into the venous sinus of the sclera, and from there into the veins of the eye.
The posterior chamber of the eye is narrower, located between the iris, the lens and ciliary body, communicates with the anterior chamber of the eye through the pupil.
Due to the circulation of aqueous humor, the balance between its secretion and absorption is maintained, which is a factor in the stabilization of intraocular pressure.
1. Yakubovich's cranial nucleus is located:
1.in the diencephalon
2.in the medulla oblongata
3. in the midbrain
4.in the final brain
2. In which part of the brain is the Yakubovich nucleus
1.in intermediate
2.in oblong
3. average
4.in the end
3. Dorsal nucleus vagus nerve is an:
1.motive
2.sympathetic
3. parasympathetic
4.sensitive
4. Parasympathetic conductors are composed of:
1.I pair of head nerves
2. II pairs of head nerves
3. III pairs head nerves
4 V pairs of head nerves
5. Parasympathetic ganglia include:
1.upper mesenteric node
2.spinal ganglion
3. pterygopalatine ganglion
4. celiac ganglion
6. Parasympathetic innervation of the pelvic organs is carried out from:
2.lateral intermediate nuclei of the thoracic segments of the spinal cord
3.lateral intermediate nuclei of the lumbar segments of the spinal cord
4. lateral intermediate nuclei of the sacral segments of the spinal cord
7. Sympathetic centers are located in the following section of the central nervous system:
1.in the midbrain
2.in the medulla oblongata
3. in the spinal cord
4 in the diencephalon
8. The pterygopalatine ganglion receives preganglionic conductors from
1.Yakubovich and Perlia kernels
2.dorsal nucleus of the vagus nerve
3.
4.lower salivary nucleus
9. The intermediate lateral nuclei of the gray matter of the spinal cord lie in:
1.the anterior horns of the gray matter of the spinal cord
2.the posterior horns of the gray matter of the spinal cord
3. lateral horns of the gray matter of the spinal cord
4.in the central part of the gray matter of the spinal cord
10. From which autonomic nuclei is parasympathetic innervation of the pelvic organs carried out
1.dorsal nucleus of the vagus nerve
2.lateral intermediate nuclei of the thoracic segments
3.lateral intermediate nuclei of the lumbar segments
4. lateral intermediate nuclei of sacral segments
11. What vegetative nodes belong to the X pair
1.paraorganic
2. intramural
3.separavertebrates
4.prevertebrates
12. White connecting branches have:
1.all spinal nerves
2. thoracic spinal nerves
13. Which nerves are involved parasympathetic fibers to the pelvic organs
1.large and small visceral nerves
2.lumbar visceral nerves
3.sacral visceral nerves
4. pelvic visceral nerves
14. From which nucleus do the vegetative conductors of the intermediate nerve originate?
1.dorsal nucleus of the vagus nerve
2. upper salivary nucleus
3.lower salivary nucleus
4.Yakubovich kernels
15. In which department of the central nervous system the sympathetic centers are located
1.in the midbrain
2.in the rhomboid brain
3. in the spinal cord
4.in the diencephalon
16. Which nucleus of the gray matter of the spinal cord is sympathetic
1. own
2.breast
3.intermediate medial
4 intermediate lateral
17. Sympathetic conductors are directed along the gray connecting branches to:
1.the organs of the head and neck
2.the organs of the breast
3.the bodies abdominal
4. some
18. White connecting branches contain:
1.parasympathetic preganglionars
2.parasympathetic postganglionars
3. sympathetic preganglionars
4.sympathetic postganglionars
19. Gray connecting branches have:
1. all spinal nerves
2.thoracic spinal nerves
3.sacral spinal nerves
4.coccygeal spinal nerves
20. Celiac (solar) plexus innervates:
1.the organs of the neck
2.the organs of the chest cavity
3. upper abdominal organs
4.pelvic organs
21. The solar plexus contains:
1.sympathetic fibers
2.parasympathetic fibers
3. motor conductors
4.sensitive fibers
22. Gray connecting branches contain
1.parasympathetic preganglionic fibers
2.parasympathetic postganglionic fibers
3.sympathetic preganglionic fibers
4. sympathetic postganglionic fibers
23. Gray connecting branches represent the path of sympathetic conductors to
1.to the organs of the head and neck
2.to the organs of the chest
3.to the abdominal organs
4. to catfish
24. Internal nerves contain:
1.only sympathetic preganglionars
2.only sympathetic postganglionars
3. sympathetic preganglionars and postganglionars
4.sympathetic and parasympathetic preganglionars
25. Spinal nerves with gray connecting branches
1. all
2.none
3.only breast
4.only sacral
26. The solar plexus innervates the organs
1. upper abdominal floor
2.middle floor of the abdominal cavity
3.lower floor of the abdominal cavity
4.thoracic cavity
27. Topography of the solar plexus
1.the anterior semicircle of the thoracic aorta
2. anterior semicircle of the abdominal aorta
3.aortic bifurcation
4.the anterior semicircle of the inferior vena cava
28. In which part of the brain the pupillary reflex arc closes
1.in intermediate
2. on average (at the level of the upper hillocks)
3.Average (at the level of the lower hills)
4.in the bridge
29. Which nerve carries out the parasympathetic innervation of the bladder
1.wandering
2.large visceral
3.sacral viscera
4. pelvic viscera
30. The vegetative conductors of the intermediate nerve begin:
1.from the dorsal nucleus of the vagus nerve
2. from the upper salivary nucleus
3.from the lower salivary nucleus
4.from Yakubovich's core
31. In the innervation of the stomach are involved:
1. celiac plexus
2.upper mesenteric plexus
3.inferior mesenteric plexus
4.hypogastric plexus
32. The branches of which vegetative plexuses are involved in the innervation of the liver
1. sunny
2.upper mesenteric
3.inferior mesenteric
4.hypogastric
33. The branches of which vegetative plexuses are involved in the innervation of the spleen
1. sunny
2.upper mesenteric
3.inferior mesenteric
4.hypogastric
34. The branches of which vegetative plexuses are involved in the innervation of the uterus and its appendages
1.solar
2.upper mesenteric
3.inferior mesenteric
4. hypogastric
35. In the innervation of the small intestine takes part:
1. celiac and superior mesenteric plexus
Short review vegetative innervation internal organs (anatomy)
Stories and comments (start)
In Human Anatomy, edited by Honored Scientist of the RSFSR, Professor M.G. Weight gain is a chapter that gives a brief overview of the autonomic innervation of organs and, in particular, the innervation of the eye, lacrimal and salivary glands, heart, lungs and bronchi, gastrointestinal tract, sigmoid colon and rectum and urinary bladder, as well as blood vessels. All this is necessary to build a logical chain of evidence, but it is too cumbersome to bring everything, in the form of quotations, - it is enough to cite one quotation concerning only the innervation of the lungs and bronchi, and in the future only adhere to the main semantic content (while maintaining the form of presentation of the material), already covered in anatomy, autonomic innervation of organs.
Describing real-life cases and comments to them, I will not adhere to the classical sequence practiced in the presentation of the pathology of internal organs, because this work is not a textbook. As well as to observe the exact chronology of these cases, too, I will not. In my opinion, such a form of information presentation, despite some seeming confusion, is the most convenient for perception.
And now is the time to turn to a brief overview of the autonomic innervation of internal organs and bring that fundamental quote on which the entire evidence base of this "Concept" is based.
Innervation of the lungs and bronchi
The afferent pathways from the visceral pleura are the pulmonary branches of the thoracic sympathetic trunk, from the parietal pleura - nn. intercostals n. phrenicus, from the bronchi - n. vagus.
Efferent parasympathetic innervation
Preganglionic fibers begin in the dorsal autonomic nucleus of the vagus nerve and go as part of the latter and its pulmonary branches to the plexus pulmonalis, as well as to the nodes located along the trachea, bronchi and inside the lungs. Postganglionic fibers are directed from these nodes to the muscles and glands of the bronchial tree.
Function: narrowing of the lumen of the bronchi and bronchioles and the secretion of mucus; vasodilation.
Efferent sympathetic innervation
Preganglionic fibers emerge from the lateral horns of the spinal cord of the upper thoracic segments (Th2 – Th6) and pass through the corresponding rami communicantes albi and the border trunk to the stellate and upper thoracic nodes. From the latter, postganglionic fibers begin, which pass as part of the pulmonary plexus to the bronchial muscles and blood vessels.
Function: expansion of the lumen of the bronchi. Constriction and sometimes dilation of blood vessels "(50).
And now, in order to understand why the spears are broken, it is necessary to imagine the following situation.
Suppose that there was a violation in the thoracic spine, at the Th2-Th6 level (thoracic segments of the spinal column): a physiological block has arisen, or, in other words, a banal displacement of the vertebra (for example, due to trauma) has occurred, which led to compression of soft tissues, and, in particular, the spinal ganglion or nerve. And as we remember, the consequence of this will be a violation of the conduction of bioelectric current, in this case, to the bronchi; moreover, the effect of sympathetic autonomic innervation, which expands the lumen of the bronchi, will be excluded (or reduced). This means that the effect of the parasympathetic part of the autonomic nervous system will prevail, and its function is to narrow the lumen of the bronchi. That is, the absence of the influence of the efferent sympathetic innervation, which expands the bronchial muscles, will lead to the predominant influence of the parasympathetic autonomic innervation of the bronchi, which will result in their narrowing. That is, there will be a spasm of the bronchi.
If the conduction of electric current to the bronchi is disturbed, an electrical (i.e. electromagnetic), and therefore energy, imbalance will immediately appear in them. Or, in other words, asymmetry, in the tension of sympathetic and parasympathetic innervation, or, in other words, a value other than zero.
After unblocking the motor segment of the spine, the conduction of bioelectric current to the bronchi from the sympathetic nervous system will be restored, and this will mean that the bronchi will begin to expand. And the balance of sympathetic and parasympathetic autonomic innervation, in particular of the bronchi, will be restored.
Energy imbalance, I think, can be simulated on a computer or measured empirically.
During my practice, as a chiropractor, I had more than one case when I managed to stop attacks of bronchial asthma and suppress the cough reflex in patients, unblocking the thoracic spine. Moreover, always fast and for everyone.
Once I had to work with a patient (a woman in her 40s) who fell into an ice hole at the age of 10. Her own father saved her, but since then she had a constant coughing, and she was registered at the dispensary for chronic bronchitis... However, she turned to me for a completely different reason - in connection with arterial hypertension. And I, as usual, worked with the spine. But what was the surprise of this woman (and mine, of course) when she noted the absence of coughing and the fact that it became easier for her to breathe ("breathed deeply"). The blockage in the motor segment of the spinal column persisted for thirty years, and disappeared in a week.
The four following quotes perfectly illustrate the capabilities of the nervous system, in particular, and the body, in general, and, most importantly, manual therapy.
1. The goal of manipulation treatment is to restore joint function in those places where it is inhibited (blocked). "
2. "After successful manipulation, segment mobility is usually restored immediately."
3. "Manipulation causes hypotonia of muscles and connective tissue, while patients experience a feeling of relief and at the same time a feeling of warmth. All this happens instantly."
4. And, "that the strength of the relaxed muscles after manipulation can increase instantly" (51).
Although the authors of the above statements referred them only to the motor segment, and, one must think, not in any way to what is said in this work, I nevertheless take the liberty of affirming what I assert. On the direct connection of displacements or subluxations in the motor segment of the spinal column and the occurrence of diseases of internal organs. The consequence of the displacements is the appearance of functional blocks in the compromised areas of the spine, which, in turn, leads to multilevel combinations of displacements in the entire spine, on which the pathogenesis of all diseases in humans and animals, too, is based. And the above quotes only confirm the effectiveness of this method of treatment and, indirectly, all my conclusions. From my experience in treating internal pathology with the help of manipulations from the arsenal of manual therapy, I can definitely confirm the direct connection between changes in internal organs and blocks in the spinal column, and the speed of the onset of the effect when unblocking the segments of the spine. Spasm of the smooth muscles of the bronchi and blood vessels is replaced by dilation (expansion or stretching) almost instantly. For example, status asthmaticus ceases within 3 to 5 minutes, as well as a decrease in blood pressure (if it was high) also occurs within approximately the same time frame (and even faster in some patients).
Functional blocks in the motor segments of the human spinal column (and in vertebrates, by the way, too), leading to degenerative changes in the intervertebral discs due to chronic compression of the spinal ganglia and nerves, cannot but affect the conduction of bioelectric impulses from the central nervous system to the periphery to the organs and vice versa. ... And, therefore, it is imperative, to one degree or another, to disrupt the work of internal organs, which (violations) will be a mirror image of the energy imbalance in the autonomic nervous system.
Pleurisy exudative (post-traumatic)
In 1996, in the evening, the brother of my former classmate called me from the hospital. A friend got into a car accident, as a result of which he was squeezed between the steering wheel and the seat. Moreover, the chest was squeezed so that even after he was removed from the crumpled car, he could not breathe fully.
But he did not immediately go to the doctors, believing that the problem would go away on its own. However, it did not become easier to breathe - moreover, the condition worsened, which forced him to turn to doctors.
He was admitted to the internal medicine ward, where he was diagnosed with pleural effusion.
AT pleural cavity accumulated exudate (effusion of serous fluid), which had to be removed (pumped out) in order to facilitate the work of both the lungs and the heart. He could no longer walk up to the third floor without stopping.
And it was precisely for tomorrow that the so-called pleural puncture was planned.
On the same evening, when he called, I invited him to come to my house to determine his condition and how he can be helped. And he came - barely, but he came! And that evening I worked on his spine. After the very first complex of manipulations, Anatoly began to breathe easier, and the very next day, as he later said, he climbed to the third floor of the hospital quite easily, i.e. Without stops. And on my recommendation, the next day, he refused pleural puncture, which left the doctors in confusion. And I worked with my friend's back (spine) only twice after that. And Anatoly had no more problems in this regard.
Two cases of pneumonia
One day a woman came to see me and, while listening to her lungs, I diagnosed pneumonia (pneumonia). In accordance with the requirements, she was offered hospitalization, which the patient refused; She also refused the antibiotics offered for treatment, citing the fact that she had an allergy. The diagnosis of pneumonia was confirmed by X-rays and laboratory tests.
Then I was just beginning to think about the influence of changes in the spinal column on the occurrence and course of internal pathology, and that by removing blocks in the spine changed by displacements, one can influence the course of the disease and its outcome. And at that time it was possible to restore the problematic spinal column only with the help of manual therapy.
This is what the patient was suggested by me - for which I received consent. At that time, I was just starting to practice as a chiropractor, so I had to work with the patient five times within 10 days (later I worked no more than three times with each patient), with X-ray control after a week and a half - the pneumonia was resolved. No drugs! It was 1996.
Four years later, I again had the opportunity to cure pneumonia by correcting my spine. This time with a very young woman. And here, too, no antibiotics, and again with X-ray control after the prescribed 10 days. Although, as you know - a doctor heals, but nature heals!
And everything about everything required only three complexes (sessions) of manipulations. In fairness, it must be said that medications, contributing to the elimination of bronchial spasm, I still prescribed. But, nevertheless - 10 days versus three weeks! It is during this period (21 days) that pneumonia is cured, in accordance with the classical principles of therapy. Think about it! The body, cut to the fascia, regenerates the skin to scar formation in 21 days. And the skin is a rather coarse substance, in contrast to the epithelium of the bronchi.
So what explains all three cases? And here's what. I'll start with the first case, and then in order.
The vertebrae displaced by the injury disrupted the conduction of bioelectrical impulses not only to the bronchi, but also to the intercostal muscles. The latter circumstance was the main trigger in the occurrence of effusion into the pleural cavity. Our rib cage functions like a blacksmith's bellows - when you inhale, inside the chest cavity, there is, so to speak, a rarefied space, where blood and air rush easily and unhindered, and when you exhale, the intercostal muscles, contracting, squeeze out both air and blood from the lungs ... In the event of a violation of the excursions of the edges on one side, the following situation arises. Blood is pumped to the lungs in full volume, and expelled in the smaller of the half (lungs) where the work of the intercostal muscles will be disrupted. That is, where the excursions (movements) of the ribs are not complete (i.e. not in full), conditions are created for the formation of an effusion of serous fluid, either into the pleural cavity, or into the lung parenchyma. A classic school problem with water flowing in and out of the pool through pipes with different diameters, and the question is - after what time will the pool be filled?
And as soon as the conduction of electrical impulses to the intercostal muscles is restored, the chest begins to work as a pump (the old name of the pump), which allows you to quickly expel all excess fluid from the pleural cavity, as in the case of Anatoly, or from the lung parenchyma, as the case spontaneously stopped pulmonary edema described by me in the second part of this Concept.
P.S. Serous (serum, from Latin serum - serum) or similar to blood serum or the liquid formed from it.
As for pneumonia, there is a fairly simple explanation.
The inner wall of the bronchi is lined with the so-called ciliated epithelium, each cell of which has constantly contracting villi. In the first phase, when they contract, they lie almost parallel to the outer membrane of the cell, and in the second, they return to their original position, and thus move the mucus (produced by goblet cells located under the ciliated epithelium) from the bronchi upward. (The movement of the villi resembles wheat spike in the wind). We, reflexively, swallow this mucus together with foreign particles (dust, dead epithelium of the bronchi). In the nasal cavity, almost the same, with the only difference that in the nose the villi propel mucus from the nostrils into oral cavity top down. This, by the way, is why, when the vegetative innervation is disturbed, a situation arises when too much mucus is produced (it contains more liquid and it is less viscous than normal) and the villi cannot cope with the increased volume of qualitatively changed mucus, and it runs out of the nose like water ...
So what about pneumonia or bronchitis?
In the case of displacement of the vertebrae in the thoracic region (Th2 - Th6), there is a violation of the conduction of bioelectric impulses along the sympathetic part of the autonomic nervous system, which expands the lumen of the bronchi, which will result in the predominance of parasympathetic innervation. And this is the narrowing of the lumen of the bronchi and the secretion of mucus, which cannot move upward due to spasm.
And almost ideal conditions are created for the vital activity of microorganisms (staphylococci, streptococci, pneumococci, viruses). A lot of mucus (a mixture of glycoproteins - complex proteins containing carbohydrate components), moisture, heat and no movement. That is why leukocytes and macrophages immediately rush here, which, destroying rapidly growing colonies of microbes, themselves die, turning into pus. But there is still no way out - the spasm persists! And an inflammatory focus arises. And we, doctors, already "treat - treat, treat - treat" ... The most powerful antibiotics, millions of units (units) daily, and even for three weeks. And not always successful, alas.
Do you know what is the difference between pneumonia and bronchitis?
It depends only on the level of damage (spasm) of the bronchi. If the spasm occurred just above the terminal bronchioles, then we get pneumonia. After the terminal bronchioles, there are only respiratory bronchioles, on the walls of which there are alveoli, through which gas exchange occurs. If the violation of the conductivity of the bronchial tree occurs higher, for example, in the bronchi of the eighth (lobular bronchi) order - here you are a banal bronchitis. We only treat him for two weeks. And why? But because at these higher levels, persistent narrowing of the bronchi is resolved both easier and faster. If the lesion is even higher - please, here is bronchial asthma for you! Of course, I'm exaggerating a little, but in general terms, this is exactly what happens.
Of course, in the treatment, physicians use drugs, the action of which is aimed at chemical blocking of the bronchial muscles, which excludes the influence of parasympathetic innervation leading to persistent narrowing of the bronchial lumen (with all the ensuing consequences). But since the displacement in the spinal column is not eliminated, then when drugs are canceled, everything returns to normal. That is, we are actually waiting banally for the displacement in the thoracic spine to spontaneously disappear (even without thinking about it!), And after it the predominant influence of the parasympathetic component of the autonomic nervous system, leading to spasm in the bronchi. That's all!
In the same way, one can approach the consideration of violations of the autonomic innervation of other organs, which, in principle, should be done. And let's start, or rather, continue, with the provision of autonomic control of the heart.
VEGETATIVE INERVATION OF INTERNAL ORGANS
| Parameter name | Value |
| Topic of the article: | VEGETATIVE INERVATION OF INTERNAL ORGANS |
| Category (thematic category) | Various |
AFFERENT INERVATION. INTERCEPTIVE ANALYZER
The study of the sources of sensitive innervation of internal organs and the pathways of interoreception is not only of theoretical interest, but also of great practical importance. There are two interrelated goals for the sake of which the sources of sensory and innervation of organs are being studied. The first of them is the knowledge of the structure of reflex mechanisms that regulate the activity of each organ. The second goal is to understand the pathways of pain stimulation, which is necessary to create scientifically based surgical techniques pain relief. On the one hand, pain is a signal of an organ disease. On the other hand, it can develop into severe suffering and cause serious changes in the body's activity.
Interoceptive pathways carry afferent impulses from receptors (interoceptors) of the viscera, blood vessels, smooth muscles, skin glands, etc. Feelings of pain in the internal organs can occur under the influence of various factors (stretching, compression, lack of oxygen, etc.)
The interoceptive analyzer, like other analyzers, consists of three sections: peripheral, conductive and cortical (Fig. 18).
The peripheral part is represented by various interoceptors (mechano-, baro-, thermo-, osmo-, chemoreceptors) - the nerve endings of the dendrites of the sensitive cells of the cranial nerve nodes (V, IX, X), spinal and vegetative nodes.
Nerve cells of the sensory ganglia of the cranial nerves are the first source of afferent innervation of internal organs. Peripheral processes (dendrites) of pseudo-unipolar cells follow as part of the nerve trunks and branches of the trigeminal, glossopharyngeal and vagus nerves to the internal organs of the head, neck, thoracic duodenum, liver).
The second source of afferent innervation of internal organs is the spinal nodes, which contain the same sensitive pseudo-unipolar cells as the nodes of the cranial nerves. It should be noted that the spinal nodes contain neurons that both innervate skeletal muscles and skin, and innervate viscera and vessels. It follows from this that, in this sense, the spinal nodes are somatic-vegetative formations.
The peripheral processes (dendrites) of the neurons of the spinal nodes from the trunk of the spinal nerve pass as part of the white connecting branches into the sympathetic trunk and pass in transit through the ᴇᴦο nodes. To the organs of the head, neck and chest, afferent fibers follow as part of the branches of the sympathetic trunk - heart nerves, pulmonary, esophageal, laryngeal-pharyngeal and other branches. The main mass of afferent fibers passes to the internal organs of the abdominal cavity and pelvis as part of the visceral nerves and further, passing through the ganglia of the vegetative plexuses, and along the secondary plexuses reaches the internal organs.
Afferent vascular fibers - peripheral processes of sensitive cells of the spinal nodes - pass to the blood vessels of the limbs and the walls of the trunk as part of the spinal nerves.
Thus, afferent fibers for internal organs do not form independent trunks, but pass through the autonomic nerves.
The organs of the head and blood vessels of the head receive afferent innervation mainly from the trigeminal and glossopharyngeal nerves. The glossopharyngeal nerve takes part in the innervation of the pharynx and the vessels of the neck with its afferent fibers. The internal organs of the neck, chest cavity and the upper “floor” of the abdominal cavity have both vagal and spinal afferent innervation. Most of the internal organs of the abdomen and all organs of the pelvis have only spinal sensory innervation, i.e. their receptors are formed by dendrites of the cells of the spinal nodes.
The central processes (axons) of pseudo-unipolar cells enter the brain and spinal cord as part of the sensory roots.
The third source of afferent innervation of some internal organs are vegetative cells of the second type of Dogel, located in the intraorgan and extraorganic plexuses. The dendrites of these cells form receptors in the internal organs, the axons of some of them reach the spinal cord and even the brain (I.A. Bulygin, A.G. Korotkov, N.G. Gorikov), following either as part of the vagus nerve or through sympathetic trunks in posterior roots of the spinal nerves.
In the brain, the bodies of the second neurons are located in the sensitive nuclei of the cranial nerves (nucl. Spinalis n. Trigemini, nucl. Solitarius IX, X nerves).
In the spinal cord, interoceptive information is transmitted through several channels: along the anterior and lateral spinal-thalamic pathways, along the spinal-cerebellar pathways and along the posterior cords - the thin and wedge-shaped bundles. The participation of the cerebellum in the adaptive and trophic functions of the nervous system explains the existence of broad interoceptive pathways leading to the cerebellum. Thus, the bodies of second neurons are also located in the spinal cord - in the nuclei of the posterior horns and the dorsal zone, and similarly in the thin and wedge-shaped nuclei of the medulla oblongata.
The axons of the second neurons are directed to the opposite side and, as part of the medial loop, reach the nuclei of the thalamus, and in a similar way, the nuclei of the reticular formation and the hypothalamus. Hence, it follows that, in the brain stem, firstly, a concentrated bundle of interoceptive conductors is traced, following in a medial loop to the nuclei of the thalamus (neuron III), and secondly, there is a divergence of vegetative pathways going to many nuclei of the reticular formation and to the hypothalamus. These connections ensure the coordination of the activities of numerous centers involved in the regulation of various autonomic functions.
The processes of the third neurons go through the posterior leg of the inner capsule and end on the cells of the cerebral cortex, where perception of pain occurs. Usually these sensations are diffuse in nature, do not have precise localization. I.P. Pavlov explained this by the fact that the cortical representation of interoceptors has little life practice. So, patients with repeated attacks of pain associated with diseases of internal organs, determine their localization and nature much more accurately than at the onset of the disease.
In the cortex, autonomic functions are represented in the motor and premotor zones. Information about the work of the hypothalamus enters the cortex of the frontal lobe. Afferent signals from the respiratory and circulatory organs - to the insular cortex, from the abdominal organs - to the postcentral gyrus. The cortex of the central part of the medial surface of the cerebral hemispheres (limbic lobe) is similarly part of the visceral analyzer, participating in the regulation of the respiratory, digestive, urogenital systems, metabolic processes.
Afferent innervation of internal organs is not segmental in nature. Internal organs and vessels are distinguished by a variety of pathways of sensory and innervation, most of which are fibers originating from the nearest segments of the spinal cord. These are the main ways of innervation. The fibers of the additional (roundabout) ways of innervation of internal organs pass from distant segments of the spinal cord.
A significant part of impulses from internal organs reaches the vegetative centers of the brain and spinal cord through the afferent fibers of the somatic nervous system due to the numerous connections between the structures of the somatic and vegetative parts of the unified nervous system. Afferent impulses from internal organs and the apparatus of movement can go to the same neuron, which, based on the current situation, ensures the implementation of vegetative or animal functions. The presence of connections between the nerve elements of the somatic and autonomic reflex arcs causes the appearance of reflected pain, which must be taken into account when making a diagnosis and treatment. So, with cholecystitis, there are toothaches and a phrenicus symptom is noted, with anuria of the same kidney, there is a delay in urine excretion by the other kidney. With diseases of the internal organs, skin zones of increased sensitivity arise - hyperesthesia (Zakharyin-Ged zones). For example, with angina pectoris, reflected pain is localized in the left hand, with a stomach ulcer - between the shoulder blades, with damage to the pancreas - girdle pains on the left at the level of the lower ribs up to the spine, etc. Knowing the structural features of segmental reflex arcs, it is possible to influence the internal organs, causing irritation in the sphere of the corresponding skin segment. This is the basis for acupuncture and the use of local physiotherapy.
EFFECTIVE INERVATION
The efferent innervation of various internal organs is ambiguous. Organs, which include smooth involuntary muscles, and similarly organs with secretory function, as a rule, receive efferent innervation from both parts of the autonomic nervous system: sympathetic and parasympathetic, which have the opposite effect on organ function.
Excitation of the sympathetic part of the autonomic nervous system causes an increase in heart rate and intensification, an increase in blood pressure and blood glucose levels, an increase in the release of hormones of the adrenal medulla, dilation of the pupils and the lumen of the bronchi, a decrease in the secretion of glands (except for sweat glands), inhibition of intestinal motility, and spasm ...
Excitation of the parasympathetic division of the autonomic nervous system lowers blood pressure and blood glucose (increases insulin secretion), cuts and weakens heart contractions, narrows the pupils and bronchial lumen, increases glandular secretion, increases peristalsis and reduces the muscles of the bladder, relaxes the sphincters.
Depending on the morphological and functional characteristics of a particular organ, the sympathetic or parasympathetic component of the autonomic nervous system may prevail in the efferent innervation. Morphologically, this is manifested in the number of corresponding conductors in the structure and severity of the intraorgan nervous apparatus. In particular, the parasympathetic department plays a decisive role in the innervation of the bladder and vagina, and the sympathetic one in the liver innervation.
Some organs receive only sympathetic innervation, for example, the dilator of the pupil, sweat and sebaceous glands of the skin, hairy muscles of the skin, spleen, and the sphincter of the pupil and ciliary muscle - parasympathetic innervation. The vast majority of blood vessels have only sympathetic innervation. Moreover, an increase in the tone of the sympathetic nervous system, as a rule, causes a vasoconstrictor effect. However, there are organs (heart) in which an increase in the tone of the sympathetic nervous system is accompanied by a vasodilator effect.
Concept and types, 2018.
Internal organs containing striated muscles (tongue, pharynx, esophagus, larynx, rectum, urethra) receive efferent somatic innervation from the motor nuclei of the cranial or spinal nerves.
Knowledge of дляο origin, ᴇᴦο movements in the process of evolution and ontogenesis is important for determining the sources of the nervous supply of internal organs. Only from these positions will the innervation be understood, for example, of the heart from the cervical sympathetic nodes, and the gonads from the aortic plexus.
A distinctive feature of the nervous apparatus of internal organs is the multi-segmental nature of the sources of formation, the multiplicity of paths connecting the organ with the central nervous system and the presence of local centers of innervation. This can explain the impossibility of complete denervation of any internal organ by surgery.
Efferent vegetative pathways to the internal organs and blood vessels are two-neuronal. The bodies of the first neurons are located in the nuclei of the brain and spinal cord. The bodies of the latter are located in the vegetative nodes, where the impulse is switched from preganglionic to postganglionic fibers.
SOURCES OF EFFECTIVE VEGETATIVE INERVATION OF INTERNAL ORGANS
VEGETATIVE INERVATION OF INTERNAL ORGANS - concept and types. Classification and features of the category "VEGETATIVE INERVATION OF INTERNAL ORGANS" 2017-2018.